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The article focuses on the Australian Association of Gerontology position paper summary of lesbian, gay, transgender and intersex (LGBTI) ageing research in Australia. Topics inlcude the LGBTI ageing research that has been published in Australia and overseas and other relevant literature reviews, the survey of LGBTI ageing researchers in Australia and identified some priority future research areas, and the LGBTI ageing policy context in Australia found there have been significant developments.

The article discusses the highlights of the poster presentations at the 2018 Annual Scientific Meeting Organising Committee held in Sydney, New South Wales in Australia. Topics covered include fractured neck of femur pathway, co-development of a model of care for a multidisciplinary memory clinic in South Western Sydney, and evaluation of patient and carer perceptions towards enteral tube feeding in hip fracture inpatients.

Background: The global population is ageing rapidly and there is a need for strategies to promote health and wellbeing among older adults. Nutrition knowledge is a key predictor of dietary intake; therefore, effective educational programmes are urgently required to rectify poor dietary patterns. Digital health technologies provide a viable option for delivering nutrition education that is cost‐effective and widely accessible. However, few technologies have been developed to meet the unique needs and preferences of older adults. Objective: The aim of this study was to explore technology use among older adults and qualitatively determine the content needs and design preferences for an online nutrition education resource tailored to older adult consumers in Australia. Methods: Twenty adult participants aged 55 years and older (95% female) participated in one of four 2‐h participatory design workshops. In each workshop, prompted discussion questions were used to explore participants' technology use and preferences and to explore content needs and design preferences for an online nutrition education resource specific to older adults. Results: All participants were regularly using a range of different devices (e.g., smartphones, tablets and computers) and reported being comfortable doing so. Participants wanted a website that provided general nutrition information, practical advice and recipes. To enhance engagement, they sought a personalised resource that could be adjusted to suit their needs, included up‐to‐date information and allowed for easy sharing with others by exporting information as a PDF. Conclusions: Participatory design methods generate new knowledge for designing and tailoring digital health technologies to be appropriate and useful for the target audience. Specifically, older adults seek an online resource that has large and simple fonts with clear categories, providing them with practical advice and general nutrition information that can be personalised to suit their own needs and health concerns, with the option to export and print information into a paper‐based format. Patient or Public Contribution: Older adults actively participated in the development and evaluation process to generate ideas about potential features, functionalities, uses and practicalities of an online nutrition education resource. [ABSTRACT FROM AUTHOR]

Introduction: Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well‐being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus‐based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well‐being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions. [ABSTRACT FROM AUTHOR]

Objective: With little research investigating older Australians' experience of companion animal (pet) ownership or wildlife encounters, this paper focuses on the value of animals in their lives. Methods: Three online focus groups explored 103 older adults' lived experience of home and community, with this paper focused on interactions with animals—companion animals and wildlife. Results: Most (60%) had at least one pet, which brought love and joy into their lives. Reflexive thematic analysis identified three themes: pets as family; challenges of pet ownership; and connection to everyday wildlife and nature. Conclusions: In addition to valuing companion animals (typically cats and dogs), this research is among the first to show that some older people also develop ongoing relationships with local Australian wildlife, such as kookaburras, kangaroos, lizards and birds, which raises the possibility that fostering connections with wildlife may enhance well‐being. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists recommending home modifications in Australia are often required by funding bodies to consider 'value' and 'value for money' (VFM); however, clear guidance on how to define and apply these concepts is not always provided. This paper reports on a qualitative study examining how the concepts of value and VFM are currently understood and operationalised by occupational therapists in Australian home modification practice, with the aim of positively contributing to both policy and practice in this area. Methods: The study utilised constructivist grounded theory to collect and analyse qualitative data from 20 occupational therapists who were currently working across Australia and had professional experience in home modifications. Findings: The grounded theory that was derived from the analysis highlights the unique position that occupational therapists occupy in home modification work as they strive to align the values of different stakeholders to create solutions that all consider to be valuable. In the absence of consistent frameworks or methods for determining value and VFM, evidence also emerged of occupational therapists using a range of individual approaches such as using formal and informal care as metrics, cheapest option approaches, and comparative costing. Conclusion: In addition to a clear need for consistent and transparent approaches to understanding and operationalising VFM in home modifications, there is also a need for further investigation into the value systems that underpin this work. A conceptualisation of occupational therapists as street‐level policy agents has proven useful here as it highlights the position occupational therapists occupy, enacting, making, and, at times, challenging policy in day‐to‐day practice as they work to align the values of the various stakeholders. [ABSTRACT FROM AUTHOR]

Objective: To review and synthesise research related to the ageing farming workforce influence on the health and sustainability of agricultural communities. Design: Using the PRISMA framework as a guide, the CINHAL and Medline databases were searched. Search 1 used the key search terms of ageing OR aging, farm*, workforce. Search 2 used health, sustainability and 'agricultural OR farm communit*. Search 3 combined Searches 1 and 2. Search 4 followed journal citations to identify other relevant articles. A process of narrative synthesis was applied to the results through the prism of rural social capital that described the current state of knowledge and understanding under four themes. Result: Database searches and searching of citations identified 16 contemporary articles. Seven of the papers were from Australia, and the balance from five other high‐income countries. The four that themes emerged are: vulnerabilities of ageing farmers; economic and climatic drivers; social capital and sustainability; and integrative strategies, that might offer a way forward. Conclusion: Integrating these forces of nature, economics and sociology to address the ageing farming workforce and the associated health and sustainability of agricultural communities remains a major challenge for researchers, governments, the agricultural sector and rural communities. [ABSTRACT FROM AUTHOR]

The life expectancy of persons with intellectual disability is increasing, and this is often occurring concurrently with the aging of their long‐term parental carers. Research in both Australia and around the world indicates that proactive post‐parental care planning is not widely implemented, and transitions primarily happen suddenly following a personal crisis for the primary caregiver. Little focus in Australia has been placed on identifying the barriers that inhibit post‐parental care planning in rural areas, specifically in the context of the newly implemented National Disability Insurance Scheme. This paper examines the factors that limit disability services and their staff in supporting successful post‐parental care planning for individuals with intellectual disability and their aging carers in rural South Australia. Small focus groups were conducted with three groups of rural disability support workers using online technologies to assist with the participants' geographic disparity. A semi‐structured interview guide was developed prior to commencement and was used to initiate discussions on key points. A thematic analysis methodological approach was used for data analysis. There were three themes identified through the analysis; Recruitment; Provision of Care; and Retention. The key findings relating to these themes are presented and supported with exemplar quotes. This research proposes three recommendations for policy or practice change: developing a national advertising campaign for new disability staff that positively emphasizes the high‐level skillset need for proactive planning; supporting rural disability providers to collaborate to establish shared teams of staff with expertise in post‐parental care planning; and, using incentive payments to retain staff with these invaluable skillsets in the disability sector. [ABSTRACT FROM AUTHOR]

A number of empirical studies document that people tend to become more risk averse as they get older. But other studies find only little evidence that age matters for financial risk attitudes. This prompts a call for revisiting the relationship between age and risk attitude to better support policy recommendations. The current paper contributes to this effort by utilising large‐scale population data to conduct a dynamic panel analysis. Care is taken to avoid the problem of endogeneity of lagged risk attitude in modelling its effects. Analysis reveals that individuals' past risk attitude has a positive effect on their current risk attitude. However, there is only little evidence that risk attitude and age are systematically related. Our results shed some light on the previous contradictory empirical findings in the literature and suggest that past risk attitude is potentially of greater relevance than chronological age in determining current risk attitude. [ABSTRACT FROM AUTHOR]

Objective: This paper draws attention to the rapidly growing number of Australian nonagenarians, presents previously unpublished information on this sub‐group of older people and explores the implications for future patterns of service delivery, planning and policy. Methods: Statistical analyses of Census data and other Australian Bureau of Statistics Surveys using Table Builder Pro, combined with analysis of de‐identified Australian Institute of Health and Welfare (AIHW) unit record data on aged care and AIHW GRIM (mortality) data. Results: Male nonagenarians almost doubled from 2006 to 2016, while their female counterparts grew by 55%. This cohort is the first to reap cumulative advantage from the dramatic reduction in death rates from 1970. Their demographic circumstances reveal both changes and continuities compared to the previous cohort. Conclusion: Men and women aged 90 and over use a substantial proportion of aged care services, and their characteristics and circumstances are highly relevant to planning current and future aged care services. [ABSTRACT FROM AUTHOR]

Making allowance for the ageing structure of the population, this paper calculates the levels of optimal national saving and future living standards for Australia for the period 1999-2050. For this period, the optimal saving response to the ageing of the Australian population is for national saving to increase from its current level by 2.7 per cent of GDP by the year 2017 and then to decline to the year 2050. The implied growth of living standards is 1.20 per cent per year. Reduced immigration would reduce the rate of growth of living standards but reduced fertility would not. [ABSTRACT FROM AUTHOR]

This paper makes new projections of government social outlays for Australia. The calculations suggest that government social outlays will increase considerably as a percentage of GDP over the next 50 years; by 7.3 per cent of GDP in the base case. This is a greater increase than that found by previous investigation. Over 60 per cent of this increase will occur between 2011 and 2031, the years when the baby boom generation retires. The major contribution to this increase will have come from increased government outlays on social security. Lower rates of net immigration are shown to yield an even larger increase in the percentage of government social outlays in GDP. The paper also considers the disincentive effect of taxation and the effect of increasing the age of retirement. However, notwithstanding the trends suggested by the projections, the paper argues that there are a number of reasons to be sanguine about the implications of ageing on the share of government outlays in GDP. [ABSTRACT FROM AUTHOR]

This paper outlines the development of culturally safe services for older lesbian, gay, bisexual, transgender and intersex people. It draws on a framework for cultural safety, developed in New Zealand which incorporates an understanding of how history, culture and power imbalances influence the relationship between service providers and Maori people. This has been adapted to the needs of older lesbian, gay, bisexual, transgender and intersex Australians. [ABSTRACT FROM AUTHOR]

Evidence shows population ageing to be historically a product of economic development, closely associated with high living standards and national affluence. Nonetheless, fears that an aged population leads to economic stagnation and public bankruptcy are widespread. In justification for cuts to public programs and the transfer of costs and risks from the state to individuals and families, the projections of social expenditures, in particular those based on ageing, are frequently identified as overgenerous and unsustainable in many G20 countries such as Australia and New Zealand. Claims based on intergenerational research methodologies and frameworks, a relatively new and innovative approach to using data projections, have proven to be important in these policy debates. This paper explores the application of these new technologies to understanding the impact of ageing on the economy in the globalised world of the 21st century. [ABSTRACT FROM AUTHOR]

An editorial is presented in which author discusses evidence based advocacy on aging in the periodical. It mentions information on Royal Commission into Aged Care Quality and Safety which required to provide an interim report by 31 October 2019 and a final report by 12 November 2020 on aging; and also mentions information on article on the topics including Human Rights in Australia.

Objective: This paper explores women's experiences of drought in Australia. Despite the significance of drought for rural life in Australia, there is little research seeking to understand its psychological consequences. There is also a need to recognise gendered experiences of drought and for research that addresses its long-term effects as people age in prolonged drought-affected areas. Design: The study explores longitudinal qualitative data collected by the Australian Longitudinal Study on Women's Health. Free-text comments ( n = 217), collected via mailed survey at five time points (1996, 1998, 2001, 2004, 2007) from the same 77 women, were subjected to a narrative analysis. Participants: Participants from the Australian Longitudinal Study on Women's Health who were aged 45-50 when the study began in 1996. Results: Findings indicate that drought has an impact on women as they age, particularly in reference to menopause, access to support systems and retirement. Conclusion: This study concludes that the experience of drought cannot be disentangled from the realities of gender and ageing. [ABSTRACT FROM AUTHOR]

Rather than attempting to create a single integrated economic–environment model of the Australian economy, this paper presents research on the linking or soft-coupling of separate environment and economic models. The model of the environment is provided by the Australian Stocks and Flows Framework (ASFF), used to identify the significant physical challenges facing Australia in the decades ahead. To address the perceived issue of missing prices in the ASFF this research explores how the link with economic models can be made, and demonstrates several advantages of taking this approach. This paper shows the results of coupling the ASFF with two different economic models, a partial equilibrium model and a dynamic monetary circuit model, which differ substantially in their fundamental assumptions and representation of the way national economies function. This demonstrates the flexibility inherent in soft-coupling separate models, as compared with the more common approach of using fully integrated models. We find coherence of the biophysical model with the partial equilibrium model is limited as the latter does not have a system-wide extent. The coupling between biophysical and dynamic economic models demonstrates the role of increasing efficiency as a driver of economic growth and subsequent environmental degradation. Copyright © 2010 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

The Intergenerational Report (IGR) released by the Department of the Treasury of the Commonwealth of Australia in 2002 highlighted pressures that in the future would threaten the sustainability of the Australian government's budget balance. These pressures result from the growing needs of an aging population and labor shortages that will limit economic growth and taxation revenue. The IGR has become a driving force in planning government policy. The Treasurer has recently said that “the whole economic agenda of the government at the moment is drawn from the IGR.” In response, the Prime Minster and Treasurer have promoted deferred or gradual retirement as part of the solution. However, about 50% of men and 20% of women retire early as a result of ill health, indicating that poor health is potentially a limiter of economic growth. This paper reports lower labor force participation among persons with poorer health and that these persons move out of the labor force at a faster rate as they age. A range of measures suggests some decline in health in the pre-retirement age group (those aged from 40 to 64 years). This indicates that better health may be a facilitator of greater labor force participation in the baby boomer cohort. However, there is evidence that improving economic conditions in Australia leading to low unemployment has created an environment more favorable to the employment of older workers with health problems as there has been a rise in labor force participation in these groups, and measures to prevent chronic disease may further increase the employment prospects. [ABSTRACT FROM AUTHOR]

Population ageing and low fertility rates are placing the Australian workforce in the twenty-first century under pressure. Aged care is one of the key areas of the workforce in which labour shortages can be expected. This is likely to result in calls for these shortages to be increasingly addressed by the recruitment of more immigrant care workers, both skilled and unskilled. Using demographic projections and the limited data available on the current workforce, this paper examines the existing levels of migrant representation and considers the prospects for future increases in overseas-born workers. The evidence shows that staff born outside Australia already compose a significant proportion of the workforce. Immigrants are not, however, equally distributed through the workforce, but are concentrated geographically in metropolitan areas. Those born overseas are also concentrated occupationally, although there is no simple pattern of confinement of migrants to low-paid or unqualified positions. [ABSTRACT FROM AUTHOR]

This paper analyses the fiscal pressure from population ageing using an intertemporal CGE model, applied to Australia, and compares the results with those of a recent government-commissioned study. The latter study uses an alternative modelling approach based on extrapolation rather than optimising behaviour of consumers and firms. The deadweight losses from the fiscal pressure caused by population ageing are equivalent to an annual loss of consumption of $260 per person per year in 2003 dollars in the balanced-budget scenario. A feasible degree of tax smoothing would reduce this welfare loss by an equivalent of $70 per person per year. Unlike the extrapolation-based model, the CGE approach takes account of feedback effects of ageing-induced tax increases on consumption and labour supply, which in turn impact on the ultimate magnitude of fiscal pressure and therefore tax increases. However, a counterfactual simulation suggests that the difference in terms of deadweight losses between the two modelling approaches is modest, at about $30 per person per year. [ABSTRACT FROM AUTHOR]

The ageing of Australia's 5.5 million baby boomers (born 1946–1965) will significantly change Australian society, yet it is unclear what is known about the expectations and plans of this cohort for their retirement and old age. This paper provides a first step by reviewing the Australian literature, focusing on the areas of health, housing, work and income, and responsibility. Information from the peer-reviewed literature and the Internet published during 1996–2005 was reviewed. One hundred ninety-five Australian references were retrieved, of which only 94 were relevant. The review identified that, despite agreement about the significance of baby boomer's ageing, empirical work directly addressing the research topics was rare. In particular, there was little coverage of baby boomers’ ascription of responsibility for their welfare in older age. If policies are to be effective, empirical research obtaining information directly from baby boomers is required to fill the gaps identified through this review. [ABSTRACT FROM AUTHOR]

This paper provides an overview of a research project that investigated strategies to address the workforce crisis currently threatening the provision of health and residential care services to Australia's rapidly ageing population. Underpinning this project's development was the need to understand why, in the face of high levels of sustained mature age unemployment (and under-employment) and the urgent need for staff in residential and community aged care, mature aged people do not consider, or are unable to undertake, further education and training to gain the necessary skills to work in this particular area.This descriptive and exploratory study used a combination of quantitative and qualitative research methods. Informed by a critical review of the literature, data were collected from interviews with four participants (aged 40 years or older) as they undertook specific education and training in aged care services, and from a survey of 145 randomly selected mature aged unemployed (and under-employed) persons. The survey and specific education and training program were located in South Australia.Findings from this study suggest that, for the mature aged unemployed person, age represents the single most significant barrier to obtaining paid employment. Evidence also exists to suggest a positive relationship between ageing and a person's willingness to undertake formal education, and/or to consider the work of caring for older people as a reasonable career option. However, the extent to which other factors such as health, time spent in unemployment (or under-employment), type of qualification, and the psychological impact of being unemployed might have had an effect remains unclear.This study challenges us to rethink how we value ageing, mature aged unemployment, mature aged education and aged care work. The findings have implications for the future of mature aged job seekers and the provision of adequate staffing for residential and community aged care services. [ABSTRACT FROM AUTHOR]

This paper looks at facts, issues and debates surrounding the potential impact of immigration on the Australian population. Some of the topics looked at are the orthodox view of aging and immigration, immigration composition, immigration numbers versus rates, dependency measurement, dependency costs, and population policy and research. The paper concludes that immigration has a significant impact on social expenditures in Australia.

An introduction is presented in which the editor discusses various topics tackled within the issue, including rural ageing, information and communication technology (ICT), and decision-making of older people.

In this paper, I focus on the transnational care practices of Salvadoran refugees living in Perth (Western Australia) and who care for their ageing parents who have remained in their home country. The analysis is based on a conceptualization of transnational care as a set of capabilities that include, but are not limited to, mobility, social relations, time allocation, education and knowledge, paid work and communication (Merla and Baldassar, 2011). I focus in particular on the impact of Salvadoran refugees' difficult access to, and use of, these capabilities on their capacity to fulfil their culturally defined sense of obligation to care for their ageing parents. Results show that extended transnational kinship networks play a major role in helping migrants overcome obstacles to transnational caregiving. [ABSTRACT FROM AUTHOR]

Background This paper reports on the feasibility and outcomes of a transition to retirement programme for older adults with disability. Without activities and social inclusion, retirees with disability are likely to face inactivity, isolation and loneliness. Methods Matched intervention and comparison groups each consisted of 29 older individuals with disability. There were 42 men and 16 women with a mean age of 55.6 years While attending their individual mainstream community group 1 day per week, intervention group participants received support from community group members trained as mentors. We assessed participants' loneliness, social satisfaction, depression, life events, quality of life, community participation, social contacts, and work hours before and 6 months after joining a community group. Results Twenty-five (86%) of the intervention group attended their community group weekly for at least 6 months. They increased their community participation, made an average of four new social contacts and decreased their work hours. Intervention participants were more socially satisfied post-intervention than comparison group members. Conclusions The results demonstrate that participation in mainstream community groups with support from trained mentors is a viable option for developing a retirement lifestyle for older individuals with disability. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses the topics include research priority areas, aimed at optimizing the availability of a range of age-friendly accommodation; changing needs of older Australians; and reflections and draws attention to key research.

Objective: The aim of the study was to improve the measurement of ageing in Oceania taking into account characteristics of populations and, in particular, changes in life expectancy. Method: Using past and projected life tables, we calculated prospective old age dependency ratios (POADRs) to 2060, placing the boundary to old age at a moving point with a fixed remaining life expectancy (RLE) for thirteen territories of Oceania. Results: In some territories, POADRs grow less rapidly than old age dependency ratios (OADRs). For example, in Australia and Guam, the OADR is forecast to increase from 0.20 and 0.07 in 1980, respectively, to 0.45 and 0.39 in 2050‐55, while the POADR is forecast to increase from 0.17 and 0.07 to 0.19 and 0.19, respectively, over the same period. Conclusion: Policymakers may consider this more rational approach to measurement when considering holistic policy responses to both current issues relating to ageing and mitigating against future challenges. [ABSTRACT FROM AUTHOR]

This paper takes a differential demographic change in six rural settlement categories within rural and regional Australia as the starting point for the measurement of differential ageing using a Relative Ageing Index which compares ageing in sub-populations with the national norm. The spatial units employed are 412 rural communities, approximated by social catchments each consisting of a country town and its surrounding dispersed population. The study covers the period from 1981 to 2006 and includes the rural areas of New South Wales, Victoria, and South Australia, excluding major cities, peri-urban areas, and the remote rangelands. It examines demographic change and differential ageing in a selection of the rural settlement categories recommended for further analysis in the report of the 'Demographic Change and Liveability Panel', one of three advisory panels established in 2010 by the then Commonwealth Government seeking to develop a sustainable population strategy for Australia. Ageing profiles are produced for the whole study area, for the individual rural settlement categories, and for the urban and rural components within each category separately. Results show that differential ageing is least advanced in the 'regional cities', most advanced in the 'sea change', but of most concern in the agriculture-based rural settlement categories where it exacerbates the effects of overall population decline. In all categories, ageing in the dispersed rural population element exceeded that of the urban component. Results emphasise the vital role of the 'regional cities' category in future public policy development supported by ameliorative and collaborative measures for their surrounding agriculture-based communities. [ABSTRACT FROM AUTHOR]

Older Australians are increasingly reliant on automobiles as their sole form of transport. As our population is ageing and the prevalence of dementia is increasing, it is anticipated that the number of drivers with dementia will rise over time. Much of the literature relating to driving and dementia focuses on safety rather than mobility. The objective of this paper is to highlight several topical ethical issues that pertain to Australian drivers with dementia. It is recommended that future research, policy and practice should centre on the crucial mobility and transport needs of our senior citizens. [ABSTRACT FROM AUTHOR]

This paper undertakes a comprehensive review of the growing international literature on age-friendly communities. It examines a range of approaches and identifies the key attributes associated with creating a sustainable environment for seniors. The authors critically evaluate emerging policy trends and models and suggest directions for future research attention. The discussion provides important information and insights for the development of ageing policy and planning in Australia. [ABSTRACT FROM AUTHOR]

Japan's demography has changed dramatically, and with it, Japanese society and the circumstances of older people. These changes include shifts in family roles and functions, employment and social relations. Traditionally, families provided financial, physical and psychological support to their parents in the same household. While the proportion of older Japanese who live with adult children is still high in comparison to the rate in Western developed countries, patterns of care in Japan are gradually shifting towards the Western model. Public pensions supply financial support and the Long-Term Care Insurance System (LCIS) provides substantial physical care for frail older people. This paper focuses on current issues for older people in Japan, and provides a brief comparison with the situation in Australia. Japan's LCIS provides a simpler and more consistent basis for funding long-term care than Australia's system. On the other hand, Australia's pension system is comparatively robust. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports the culmination of a local process of priority setting for ageing research. Methods: A cross-sectional random community mailout was conducted across 1500 Hunter region, Australia, households during 2001, using the modified Dillman procedures. The survey included 38 research topics and priority items. Research priorities were grouped according to factors identified by factor analysis. Results: There were 694 respondents. Four research priority factors were identified: age-related diseases, symptoms and problems of ageing, lifestyle factors, and mental and social issues of ageing. Top-rating priorities were stroke, dementia, heart disease and cancer. Overall, more women and older people (65+ years) ranked items as very important. Lifestyle factors were mentioned most often as the most important health and social issues facing older people. Conclusions: Community views should be considered where evidence and researcher interest can support this. [ABSTRACT FROM AUTHOR]

Objectives: It is well known that there are associations between overall health, age, socioeconomic status and rural residency. The objective of this study was to determine the distribution of Australia's aged population by socioeconomic status, as well as remoteness. Methods: The study employed the Australian Statistical Geography Standard (Statistical Area Level 1 and Remoteness Areas). The database of the geographic boundaries was integrated into the ageing population and socioeconomic data using the Geographic Information System. The socioeconomic data was analysed through the Index of Relative Socioeconomic Disadvantage. Results: Over a decade, the older population in Australia has increased noticeably. In 2016, there was a high percentage of older people (≥65 years) in Tasmania (Tas), 19%, while the lowest percentage was recorded in the Northern Territory (NT), 7%. Across the country, Tasmania had the highest percentage of older citizens living in the most disadvantaged areas since 2006, with 48% recorded in 2016. There was an association between the remoteness areas and the education and income levels of the ageing cohort. However, this association differed between the states and territories. This socioeconomic gap becomes more evident in the very remote areas of the country. Conclusions: The ageing population in Australia is increasing rapidly; this was associated with an evolving socioeconomic disparity among this ageing society. Our results demonstrated that socioeconomic inequalities were to be found among the older people based on their distribution over the remoteness areas in Australia. This information should be used to target healthcare and ageing policies that meet the specific needs of older people. [ABSTRACT FROM AUTHOR]

An introduction is presented which discusses articles within the issue on topics including aged care services to the increasing number of Australians living with dementia.

Objective: This study examined older lesbian and gay adults' experiences regarding informal caregiving, including challenges and positive aspects of caregiving. Methods: Interviews were conducted with 16 lesbian women and gay men in Australia, aged 60+, who were engaged in informal caregiving. Analyses involved a qualitative thematic approach. Results: Most participants were caring for a friend or partner and regarded caregiving as a form of love and did not seek external support despite noting several impacts. Some participants found that they too were beginning to require care. For some, formal care was being considered, but with a degree of reluctance. Conclusions: Older lesbian and gay adult caregivers experience a range of challenges and support needs in relation to their experiences with the caregiving role. This research highlights a need for ensuring that caregiving policies and practices be responsive to the experiences and challenges faced by older lesbian and gay people. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to explore the impact of the COVID-19 pandemic on the financial well-being of older Australian retirees. Methods: Thirty Australian retirees (16 females and 14 males), older than 65 years of age, were asked ‘Have your finances been affected by the events surrounding COVID-19?’. Data were analysed using Braun and Clarke's six-step approach, and Bronfenbrenner’s socio-ecological model was utilised to analyse thematic responses at individual, household, community and societal levels. Results: Two COVID-19- related themes emerged from interviews: COVID-19 and increased financial stress and COVID-19 and frustration with digital banking. Conclusions: This study revealed that the financial well-being of older Australians and especially self-funded retirees has been negatively impacted by the COVID-19 pandemic. Participants felt financially worse off primarily due to the volatility of the financial markets, the need to support adult children and the increased cost of living. Also, participants expressed their hesitation and frustration with digital banking services, and their desire for greater personal contact with financial institutions, particularly during times of uncertainty. [ABSTRACT FROM AUTHOR]

Currently, individuals living in rural and remote areas experience 1.4 times the total burden of chronic disease, including an 80% greater risk of late-life cognitive impairment and dementia, 2.5 times the number of preventable hospitalisations and a reduced life expectancy of up to 12 years compared to their metropolitan counterparts. Traditionally, health service planning and public health interventions have been largely built on the needs and characteristics of metropolitan populations. This disproportional focus can contribute to significant physical and cognitive health status disparities for rural and remote communities. This article focuses on existing challenges and strategies surrounding the cognitive health of rural and remote populations and provides short and long-term opportunities involving Australian public health policy and clinical practice to innovate dementia prevention for rural and remote communities. [ABSTRACT FROM AUTHOR]

Background: Advance health directives (AHD) can be used to explore and document patient preferences for treatment and are therefore an important aspect of care planning. Aims: To investigate the prevalence and factors associated with AHD among older inpatients. Methods: This retrospective study included 6449 patients, aged ≥65 years referred for specialist geriatric consultation between 2007 and 2018 in Queensland, Australia. The interRAI‐Acute Care Comprehensive Geriatric Assessment tool was used to calculate a frailty index (FI), range 0–1, based on 52 possible deficits, and categorised into intervals of 0.1 for analysis. FI was also grouped according to previously reported cut points: fit (FI ≤0.25), moderately frail (FI >0.25–0.4), frail (FI >0.4–0.6) and severely frail (FI >0.6). Results: An AHD was present in 1032 (16.0%) of 6449 patients. Those with an AHD were significantly frailer than those without an AHD (mean FI 0.52 vs 0.45; P < 0.001). Higher frailty (odds ratio (OR): 1.34 (1.27–1.40)), older age (OR: 1.04 (1.03–1.05)), living in an institution (OR: 1.33 (1.01–1.73)) and recent hospitalisation (OR: 1.42 (1.23–1.62)) were significantly associated with higher prevalence of AHD. Prevalence of AHD increased over time, from 7.6% (n = 66) in 2008 to 35.4% (n = 99) in 2017. Conclusions: The presence of AHD is associated with sociodemographic factors, as well as higher frailty levels. Prevalence of AHD among inpatients has increased over the past decade but remains modest. [ABSTRACT FROM AUTHOR]

Objective: Negative attitudes towards ageing have been associated with poor mental well‐being, and protective factors are not well‐understood. This study examined the relationship between ageing attitudes and symptoms of anxiety and depression, and the potential moderating effect of age, and buffering effects of social support, physical activity and education. Methods: This study used a subsample of 482 adults aged 50+ years from a mail questionnaire study in Brisbane, Australia. Data were analysed using linear regression. Results: People with more positive ageing attitudes reported fewer symptoms of anxiety and depression, with no moderating effect of age. There was a significant interaction between ageing attitudes and education on depression, and a similar trend for anxiety. Conclusions: This study confirmed the adverse impacts of negative ageing attitudes on mental health and indicated that those with low education may be most vulnerable. This has implications for future research and targeting interventions for mental health promotion. [ABSTRACT FROM AUTHOR]

The author focuses on tensions between G20 economic agendas and Australian government policy with respect to increasing older workforce participation. Topics discussed include an analysis of national policy discourses about population ageing and increased dependency ratios, the influence of post-global financial crisis (GCF) interventions on older workforce participation trends and the consequences of G20 policies of restructuring industries and openness of global trade on ageing workforces.

This paper will focus on the provision of community aged care services via 'direct payments' and 'social enterprise'. These are two solutions that were not fully considered by the Productivity Commission as a way to make the provision of community aged care more sustainable in Australia. The empowerment component of social enterprise activities and 'direct payments' have the potential to generate improvements in the community aged care system. [ABSTRACT FROM AUTHOR]

Aim: This study attempts to identify any association between length of exposure to urban environmental risk and non-infectious chronic disease in a group of Australian residents who lived in the same location for at least 20 years. Methods: Using Australian survey data, we selected 1256 participants who were 45 years and older and had lived in the same location for at least 20 years. We used logistic regression and survival analysis to identify factors associated with the presence of non-infectious chronic disease at baseline and after 7 years. Results: Results show that increasing age, living in an urban area and living in an area with a lower socioeconomic status increase the odds of having a long-term health condition. Conclusion: This study provides empirical evidence that older long-term Australian urban residents are more likely to have a non-infectious chronic disease, which may be associated with environmental exposure, than those living in rural locations. [ABSTRACT FROM AUTHOR]

The author looks at the treatment and recovery of those with heroin addiction and related policy issues, commenting on the article "Long-term mortality, remission, criminality and psychiatric comorbidity of heroin dependence: 11-year findings from the Australian Treatment Outcome Study" by Maree Teesson and colleagues in the current issue. Topics include harm reduction, relapse, and the difference between the medical and recovery care models in mental health services.

Older Australians living in rural areas have long faced significant challenges in maintaining health. Their circumstances are shaped by the occupations, lifestyles, environments and remoteness which characterise the diversity of rural communities. Many rural regions face threats to future sustainability and greater proportions of the aged reside in these areas. The emerging changes in Australia's climate over the past decade may be considered indicative of future trends, and herald amplification of these familiar challenges for rural communities. Such climate changes are likely to exacerbate existing health risks and compromise community infrastructure in some instances. This paper discusses climate change-related health risks facing older people in rural areas, with an emphasis on the impact of heat, drought and drying on rural and remote regions. Adaptive health sector responses are identified to promote mitigation of this substantial emerging need as individuals and their communities experience the projected impact of climate change. [ABSTRACT FROM AUTHOR]

International covenants and domestic social policies in most developed countries regard people with intellectual disability as citizens with equal rights, suggesting they should have the similar aspirations of a healthy and active old age as the general community, and an expectation of the necessary supports to achieve this. This article compares the development and implementation of accommodation support policies for people aging with intellectual disabilities in five liberal welfare states. It describes the limited development of policies in this area and suggests possible reasons why this is the case. A review of the peer reviewed and grey or unpublished advocacy and policy literature on aging policies for people with intellectual disability was conducted which covered Australia, Canada, Ireland, the UK, and the U.S. Despite consistent identification of similar broad policy issues and overarching goals, little progress has been made in the development of more specific policies or implementation strategies to address issues associated with accommodation support as people age. Policy debates have conceptualized the problem as aging in place and the shared responsibility of the aged-care and disability sectors. This may have detracted from either sector leading the development of, or taking responsibility for, formulating, implementing, and resourcing a strong policy framework. [ABSTRACT FROM AUTHOR]

Objective: To explore health professionals' (clinicians) approach to the provision of care in a dementia setting. Methods: Participants were clinicians from two older persons' mental health services (community and inpatient). Participants completed an interview about strategies to engage with, and barriers to providing person‐centred care to consumers with a co‐morbid diagnosis of dementia. Thematic analysis was used to analyse the data. Results: Three main themes were developed through analysis of the interview data: (1) overall approach to care (synthesis of care and cure principles), (2) the challenges in the provision of care, and (3) coping strategies to manage care demands. Conclusion: Developing a relationship with a patient and attending to their medical needs were seen as optimal care, relevant to both person‐centred and task‐oriented approaches to dementia care. Clinicians also highlighted the importance of their own personal resources and attitudes in shaping the type of care provided. [ABSTRACT FROM AUTHOR]

Objectives: To explore perceptions and expectations regarding aged care among older Forgotten Australians, informing better ways of delivering safe and inclusive care for this group. Methods: In‐depth interviews were undertaken with sixteen Forgotten Australians to understand their perspectives, hopes and perceived barriers to receiving appropriate aged care. Qualitative data were analysed using Ritchie and Spencer's framework approach. Results: Participants were highly averse to receiving aged care in residential settings, particularly where delivered by religious organisations. Limited perceived opportunities to develop trust and maintain control and independence while managing re‐traumatising situations shaped Forgotten Australians negative perceptions of the aged care system. Participants also spoke of how their lifelong marginalisation could limit their access to choice and quality in aged care. Conclusion: The aged care industry could provide safe and inclusive care by adopting a person‐centred and trauma‐informed model that recognises and addresses the specific needs and challenges of Forgotten Australians. [ABSTRACT FROM AUTHOR]